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Importance of Hearing Healthcare in Senior Living

Untreated hearing loss impacts seniors and their families in numerous ways. Learn first hand from Nate Salisbury, Director of Network Development at Sunrise Senior Living, how seniors are affected and what can be done to help them.



Hi, I'm Jim Cuddy and this is Ask The Hearing Doctors. And I'm joined today by Dr. Ana Anzola, doctor of audiology with Hearing Doctors. The Washington DC area's highest-rated audiology practice with over 1500, five-star reviews. And also joining us today Nate Salisbury, Director of Network Development with Sunrise Senior Living. Ana great to see you, Nate thanks for being here. Thank you.

So Nate, hearing loss in senior living. What is the prevalence of hearing loss in senior living?

So currently we're looking at about 30 percent hearing loss below the age of 75. Over the age of 75 about 50 percent hearing loss as you age. And with that 50 percent of hearing loss over over age 75 we’re looking at about 10 to 12  percent of individuals who actually take action to um combat hearing loss as they age uh in senior living.

The negative things that come with hearing loss, multitude of health conditions. Ana we've talked about some of these on the program before. What do you see on a day-to-day basis?

Sure we see cognitive decline in residents. We see the addition of depression and isolation. Are really three major components that we see in in the result of hearing loss in seniors. 

Leaving hearing impairment of any kind untreated. Number one it's got to be a battle for you I mean just trying to convince somebody or a family member how do you go about convincing their family member to to do something about it? You see it from the clinical side. You're seeing it in the community. Talk about that a little bit and and just what happens down the road as when people don't do anything about the hearing impairment that they have?

Sure it really affects residents in multiple ways. It can be physical decline. We can have additional depression or isolation. Residents can even become combative or aggressive when their hearing decreases as they age. So there's a multitude of things that happen with our seniors when hearing declines that come out as really a side effect of what's really going on with hearing loss in a community senior living environment.

From the clinical side when you're working with folks in the senior living community what what are you able to do to sort of help things along?  To try and convince them? Because it's probably got to be a multiple-prong approach I would think to convince these people that you know because there are lots of negative um connotations to it at least they think there are.

Right right. So one of the biggest things that we do is educate. Not only the staffing but the impact of what would be for that patient or the family members not to take action. So we come in we educate the staff members, we educate the power of attorneys or themselves and the patients themselves so that they can begin to recognize that this is something that's critical. It's critical because that's all we do is communicate. And if there's a lack of communication there's going to be a lack of compliance. And you talk about being combative because maybe you don't understand and they don't understand each other. And that's a shame. But for us when we do take action and they do recognize that there's a great benefit it's a win-win.

You mentioned hearing each other. Social engagement. Yes. There's one that I'm sure you see a lot of things that could be a lot better if people did something about their hearing impairment?

Absolutely so a couple things this can even be happening prior to someone moving into a community setting. At home, with a spouse that a spouse the communication and the listening is declining. Which can really result into just more aggravation, more frustration within the home setting between loved ones with that type of situation. But as Dr. shared you know on the other side of living in the community, if it's not being addressed with the resident or educating the family then it's really doing a disservice to that resident because it might be that's all they need is some education, a hearing screening to occur. And just the family to be notified that we have this as an option to help identify where there might be a shortfall or a gap.

So there's another part of your job that I would think is very important - convincing family members. Maybe it's somebody that's in the community that maybe they don't even maybe they're not even aware of their own hearing loss. But you know their family members are aware, you're aware of it, how do you broach that?

Well it's that's a complicated situation. But the good news is with constant care evaluation these are indicators that we look for. You know are there changes in in in their baseline? Are we noticing some different behavioral type expressions coming from that resident in the community? And we start to get maybe some red flags or indicators that a resident's not responding or maybe they're misunderstanding what's being shared with them from a caregiver or a doctor that's visiting the community. So we we identify on a routine basis where there might be opportunity and that that information is documented in the residence chart, in their medical notes, and and we're able to review that type of information, that data, those benchmarks with the family on a routine basis. To say hey let's let's hit pause you know let's look at mom or dad's care and we're noticing a change in condition with the hearing situation. Um so that is really a benchmark for us and an approach that we can take to identify and really make it easier to have an icebreaker conversation about hearing.

Yeah and and hopefully we will get those patients way before they enter the community. So from our point of view is the continuity of service. So many of those patients that that go to different facilities we have already started that baseline with them and then the continuity of service continues at those facilities. And we follow them so it's really nice for the family members and the community to know that you know that we have followed up with them.

Speaking of what people have been missing. There's a fascinating thing about the the correlation between music in your life and down the road hearing loss. Can you talk a little bit about that?

Sure it's very interesting you know living with melody in our lives. I think we can all relate to some of our favorite music. It's it's really a universal platform that we can all gravitate to is music. Okay, and it's interesting that from age 10 years old to about age 30 years old that is our time where we soak up and really lay the tracks on our memory of music and how we've enjoyed music from age 10 years old to 30 years old. And why is that important down the road as we age? It's music is really that bridge to take us back, especially if you start looking at Alzheimer's disease, dementia related illness, when you reflect back, music is always that common ground that residents and seniors and older people can pull from through the unconscious. So that's a really important key is that unconsciously we remember music from age 10 to 30 years old typically in our lives. And that really never goes away as we continue to to age.

But if you're missing it, if you're not able to hear it more of those negative health effects begin to really snowball?

It really does snowball. It's the music piece of our lives is is really critical. And that is a critical piece of really purpose that we incorporate in our type of setting, community living, is that we have music. We've made it really a high priority to have live music, to utilize technology, um to have choirs and singers, to be able for residents to have that opportunity to reminisce, relate, and just remember those times in their lives. Oftentimes music is related to other memories of family functions and those types of events that happen in their lives. 

And engagement, right? Because that's eventually that's really what we're after. To continue to be engaged, to continue to remember, to continue to share. 

Well and you know we've talked in the past and and what's important to the patient? These are the types of questions that you're asking. These are the types of questions that you are asking too. And and that's the one thing that you come back to it's like I can make this so you can hear Frank Sinatra or whoever it is you know. Or the Beatles so let's let's face it some of us are sure at that age too. 

From a business perspective, does it cost more when residents aren't hearing? 

It it does. It really does because a few factors. You have the team member engagement. You have team members that may be trying to work with a resident in the community and they're getting pushback when it comes to delivering a high level of care to somebody that may not be hearing what the care manager is is actually saying to them. It could be something as simple as what would you like for your your breakfast? And that can be interpreted as something totally different when there's hearing loss. So the frustration level and and burnout of staff really asking over and over and over and over again trying to work with the resident. 

Residents also the side effect is a decline in in cognition when there's depression, uh isolation and that really puts a factor on their care level. In being able to provide more care costs more money. So it's really all correlated together whether it's staff uh turnover on from a business perspective on that side or the resident declining and needing a higher level of care. There is an effect on the business and cost.

Right. You know and you mentioned the frustration for for the caretakers and the family members. You see it. Yeah. I'm sure you're seeing it too. So and for you you're seeing both the caretakers and the family members seeing frustration, um just another battle for you all to fight.

It it is. Uh, it really is. But the the good news is that we we have found ways to combat that and some of those ways are engaging in additional screenings. Bringing in the professional providers to support our residents. But we also dug deeper in our organization with behavioral expressions. And doing more intense training with our team members. Of for example how do you approach a resident properly? Do you if someone's in a wheelchair and they have loss of hearing not to come up behind them and talk softly into their ear. That that's an opportunity to scare them uh not have them prepared for what's going to happen next. As far as a next step of maybe care being provided. So we have done in-depth training on how do we interact uh or identify. Behavioral expressions is really an outward pouring of emotions of how someone is feeling and and why is that happening. So we teach our team members additionally how do we recognize oh maybe this resident's having a decline in in their hearing and that's why they're yelling at me or frustrated or won't let me help them to the dining room or to you know the restroom or the shower. That is really where the additional training, understanding uh the behavioral expressions of a person living in a community setting.

Right and it's the understanding point that I I want to emphasize here because we do bring the same protocols that we take here in the office. Starting with a the diagnosis of a possible hearing loss. But we also look at the cognition and the possible cognitive decline and how they interact and how we can better communicate between all of us and say you know this patient is not only suffering from a hearing loss but also also possible cognition issues that need to come into play. And so that education how to better communicate with them comes into play.

Overcoming the barriers. Overcoming the barriers. But it's just really understanding where the patient is coming from. What are they suffering from? What's the treatment plan? And what is that best communication?

Ultimately understanding where they're coming from helps you both do your jobs. Exactly. And then and then they feel good about the treatment that they're receiving. 

If you can talk to the audience that's listening today and watching us what would you tell them?

I I would tell and encourage our audience to participate in in screenings. Take advantage of the opportunities and the technology that is available for for all of us really to do routine screening, check-ins. Don't miss those opportunities to be able to identify have we had a change? And how can we address that change? Because the the positive impact and the results are just they're tremendous. For something maybe as simple as identifying a hearing change of condition that really impacts so many other parts of daily living is really important. So I would say don't miss the opportunity to do that. It's it's really uh will serve well in the end. Absolutely. Nate, thanks for all that you do and thanks for being with us today. Ana, thank you as well. Thank you. Pleasure. Thanks.

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